Thursday, August 20, 2009

Clinton and Congo

Below is an email I received this morning that is from a Blog who's source I unfortunately do not know. However I completely agree with the sentiments presented. I really hope that Mrs. Clinton and the Obama administration will think very hard about what it means to be in partnership with other countries, supporting the local organizations, versus the historical US policy of bringing in our own ideals.


change in which i don't believe

Details of the plans for U.S. foreign aid announced last week in Goma during Secretary of State Hillary Clinton's visit are slowly beginning to emerge. Of the $17 million the secretary announced, about $3 million is to go towards training police on responding to gender-based violence. As I noted last week, that's not much, and the police need training on a whole host of issues, but $3 million is better than nothing. USAID will learn the hard way that they're going to have to start way on basic professionalization (and salary payment) before most of the Congolese police force will be able to do anything about tracking down and arresting rapists.

What of the rest of the money? Part of it will go to Camcorders for Congo, of course, and the State Department has been fairly quiet on this as far as I can tell, but activist Desiree Zwanck, who works at Heal Africa hospital in Goma, gives us some details in her post on the secretary's visit (emphasis mine):

"Much needed and appreciated funds - but wait a minute. HEAL Africa, the local organization that was hosting the event, has a hospital with 7 years of experience in treating survivors of sexual violence. However, we learned only through the speech of our honored visitor that USAID is planning to construct a hospital to do the same work, in the same city. And even though Clinton claimed that funds would be distributed to local NGOs, we found out shortly afterwards that the lion’s share would go to the International Rescue Committee.

"I don’t believe Clinton had been well-informed on the dynamics of aid in Eastern DRC, though it is certainly no secret that aid is a cut-throat business. Competition for funding, attention and prestige is huge. As a result, cooperation between GOs and NGOs is lacking or poorly coordinated. Communication needs to be improved, and new initiatives need to be matched with what is already being done. What we saw happen yesterday was the opposite."

As Zwanck notes, what USAID is planning to do in Goma is almost incomprehensible. Let me get this straight:

They looked at the city - which is home to a hospital that is a model of community engagement - and decided that it would be better to build a different hospital altogether?
That was apparently decided on without consulting those who are already experts on treating rape victims in the region?
And that will lack the extensive network of community-based counselors who live in the villages and are trained to identify and assist rape victims?
And the Secretary of State told a roomfull of Congolese activists that the money would go to local organizations when in fact it's mostly going to an American NGO that bases most of its work in the eastern Congo out of Bukavu?

Some of you are ready to jump on me about "well, aren't there more victims than existing hospitals can treat?" and similar questions. Yes. It's true. More facilities to treat rape victims are desperately needed. That's why Heal Africa is fund raising for a new hospital building, and why Panzi's facilities continue to expand in Bukavu.

But it doesn't make sense to reinvent the wheel in the eastern Congo. Did USAID bother to talk to any Congolese people while developing this plan? Drs. Mukwege and Lusi and their staffs already know how to treat victims of sexual violence. They have developed hospitals and programs that are models of how to address gender-based violence in impossibly difficult situations with limited resources. They don't just treat case after case after case; Heal Africa trains medical residents to go out into the field and run clinics and hospitals on their own, and both hospitals do all they can to give women and girls who survive these attacks a chance at having a life, an income, and some hope after they leave. It makes a lot more sense to partner with the people who already do these things - and who have integrated the communities they serve into their approach - than it does to start from scratch.

There's also the issue that the International Rescue Committee is poorly perceived by a large segment of the Congolese population. That's not to discount their work - they do a lot of good & support both Panzi and Heal Africa's work - but issues relating to the 1994 genocide (There's a view common among many Congolese that the American government supported the Rwandan government after the genocide (a government that, it must be remembered, has caused a lot of suffering in the Kivus), so therefore the American IRC which gets money from the U.S. government is an ally of/spy for Rwanda.) mean that they have a huge perception problem. It's an issue. (Dennis Dijkzeul has done some very interesting research in South Kivu in this regard.) It's really unclear what the IRC money will be used for, but if most of it is going to them, presumably they will have a significant role in the hospital's construction. If this new hospital is to specifically be an "IRC hospital," I'm not sure that's such a good idea.

I am sorely disappointed in my government's failure to truly take local concerns into account, and even more disappointed that it's the Obama administration that failed to do so. This plan looks for all the world like something that was conceived in Washington, not the Kivus. It represents some of the worst habits of Africa-related policy making in American foreign aid and could not be further from representing real change. Like Zwanck, I'm forced to conclude that the secretary's visit to Goma was not the beginning of the end of the war, but rather a sign that the same old, same old will prevail in American policy towards Africa.

posted by texasinafrica at 8/19/2009


Friday, July 10, 2009

Back to Goma

I'm heading back to Goma as a team leader of a group of 9 great individuals from the First Presbyterian Church of Berkeley. To access our team blog please see:

i will update this blog with pictures when I return in August.

Thanks for checking in.

Friday, February 13, 2009

Back to the Blogging

I have been out of the Congo for 4.5 months now. After spending 6 months of my life in Goma during 2008 I find that although I am physically in Park City, UT teaching kids how to ski, I find myself constantly thinking of my friends and the current situation in Goma. It's a strange disconnectedness as I find my mind wandering back and forth with from the resort extravagances of Park City to the just as real visions and memories of the smoke laden dirt roads of Goma.

This past weekend I was in Berkeley and had a quick meeting regarding the Lotoba nutrition project and it was a great way to reconnect myself, in a way, to the project that I worked so much on last year. The program continues to run, but is in need of a few changes to ensure it is a lasing and successful program.

General Nkunda has been captured by a joint Rwandan/Congo army effort (although I'm sure Rwanda gets the lions share of credit for this) and the citizens of the eastern DR Congo are optimistic, but rightly still weary, of any promises of peace.

I've been out of touch from this Blog for quite some time and have a thousand thoughts on my mind, but I'll make this short and try to update a bit more often going forward. I find myself reading 1 Kings these days and am struck by Solomon's request for wisdom, when given the chance to ask God for anything. That in itself is wisdom. May all you who may read this strive to make your decisions from a heart that seeks to be wise rather than powerful, rich, or right.


Saturday, November 08, 2008


I spent August and September back in Goma, DRCongo setting up the Lotoba production facility with the help of Glenn Bean, Marian Roan, and input from countless friends at HEAL Africa. As a reminder Lotoba is Global Strategies for HIV Prevention's name for the Ready to Use Therapeutic Food (RUTF) that we are producing for meeting the nutritional needs of malnourished children in the North Kivu region of Congo. RUTF is a revolutionary idea for treating severely malnourished children.
There are many benefits to RUTF. It is easy for the children to consume, has all the protein, calories, vitamins and minerals that they need to become healthy children, and this in turn gives them a better chance of not only survival but also of becoming successful members of their communities as they get older. The majority of brain development occurs before the age of 3 and physical development is directly related to the nutrition children have access to before the age of 5. A child who is malnourished in these first few years of life will be at a permanent physical and mental disadvantage for the rest of their lives.
There is also a huge benefit to children with HIV. Children who have HIV can forgo the need to start Antiretroviral(ARV) drugs if they are properly nourished. ARV's are required when CD4 counts (a measure of certain white blood cells) reach a dangerously low level. And once on ARV's the child will likely require them for the rest of their lives to remain healthy. ARV's are not cheep.

Our Lotoba project will start out by feeding the HIV positive children who are being treated at the HIV clinic at HEAL Africa in Goma. Then we hope to increase production capacity to meet the needs of the other aid organizations in the region who are using RUTF's purchased elsewhere for their nutrition projects. This will be the step that allows the project to be susstainable without the continued input of raised funds from the US and elsewhere.

The pictures above show the transformation of the facility we are using between August and the end of September. I left at the beginning of October and the facility is fully functional. There is a manager and 2 full time workers, both from a local widows organization who use their wages to care for their children and provide them with educational opportunities.

The pictures below show the process of measuring and weighing the child to determine if they are malnourished. The mid-upper arm circumfrance (MUAC) measurement is the most telling. A severely acute malnourished child (ie on the verge of starvation) will have a MUAC that is just about than of a broom handle. The other measurements are height and weight.

Parents (almost always Mothers) are then given a weeks worth of Lotoba to take home where they can feed their child while still taking care of her other children. This is another huge benefit of RUTF products like Lotoba. If the child had to remain at the hospital, so would the mother. There would be a cost to keep the child at the hospital, which is likely prohibitive since the mom has to stay at the hospital with the child, and the rest of the children in the family would likely be at home under the care of the oldest child, sometimes an 8 year old taking care of 2 or 3 younger siblings for who knows how many days or oven weeks.

We are very excited about the progress of this project. I thank all those who have taken part in Hope Walks events and donated funding. Anyone interested in donating can go to Global Strategies website or mail them a check and indicate that the donation is for the Lotoba Project.

Wednesday, July 23, 2008

140.6 miles - 12h 53m 54s

Those are the statistics, but they don't tell the full story. Sunday was an experience that adjectives don't do justice. I talked to my family after the race and I told my sister that when I crossed the finish line I couldn't contain the emotion that spilled out in the form of tears. She asked what I was thinking at that moment and I honestly couldn't remember. There was no single thought, but rather an overwhelming sensation that goes hand in hand with an accomplishment like this. I would never be able to do that feeling justice by trying to describe it. I believe that part of it was also due to the knowledge of all of you who had wished me luck over the past couple of weeks. Whenever I heard a spectator cheer for their loved one "You can do this.. We love you!" I couldn't help but get choked up. It was completely reactionary and involved no analysis or deeper thought. Just like your legs involuntary reaction to a doctors gentle tap on the knee, certain comments throughout the day (especially on the run) would just get to me.

I had the chance to meet up with Rich, from Race4Kids, Saturday night and got some good race day advice from him. His daughter Elizabeth and son stayed home in Toronto with the grandparents and Rich was here this year as just a spectator. We talked for a bit about what I was doing in Africa and how Elizabeth is doing. She is getting a device removed in 4 weeks that has been used to give her medication during her Leukemia treatment. Rich and his wife said that although this is great for Elizabeth, it is actually a little hard for them. For the past year and a half they have been actively treating and fighting this disease. But now, they just have to wait and see. If she makes it 4 years without relapse she should be in the clear, but until then they just have to hope and pray that she will be fine. It was great to have this opportunity to get to know someone that I had only exchanged a few e-mails with over the last couple of months, but who's team I was/am a part of.

Race day:
Sunday started out with the alarm clock set at 4am. Breakfast, dressed (with my Race4Kids race top), transition and special needs bags packed, and then into town by 5:15. First thing was to drop off special needs bags, which are given to us halfway through the bike and run. I just had 1 water bottle with CarboPro1200 in my bike special needs bag and nothing in my run special needs bag. As I dropped them off I thought maybe I was missing something as I passed bag after bag that looked like it was full of stuff! As it turned out, I didn't need anything more than that extra bottle and what the race course provided. Next was last minute checks of my bike and then the wetsuit. Dressed for the swim we all started migrating to the lake. It was about 200 meters from the transition are to the lake and we got to see what we would be running back over after exiting the swim. I put my cap and goggles on, said a quick prayer (which would not be the last...) and wished Raf good luck. We had talked about trying to start in the same place but then realized that once we started warming up it would be impossible to find one another. Into the water I dove, to warm up for a loooong day.

2,300+ people started the swim at the same time. Generally I hear stories of these mass starts looking and feeling like a feeding frenzy in shark infested waters, so I was a bit nervous. The last thing I wanted to do was start my day with an elbow to the forehead or someone dragging my backwards by the ankle like so many horror stories I had heard. Surprisingly the swim went brilliantly for me. I ended up in some sort of bubble between the mass of people trying to swim with a view of the underwater cable marking the course, and the mass of people trying to stay away from that mass. Aside from a few legs I had to swim over and a few people grabbing at my feet, my first lap was surprisingly smooth. The theme for me during this race was "I've never gone this far before..." I had a bit more contact on my second lap but nothing to concerning. As I rounded the buy that marked 3000m finished and just 1000 to go, I thought to myself for the first time...."I've never swam this far before". But I felt good and just focused on staying relaxed and in good form.

Out of the water with an official time of 1:12:06 and in 1000 place over all. I was very happy with my swim as i was expecting 1:15 - 1:20.

Halfway through the swim, it started raining. By the time I was heading for my bike I was thinking that it may be a good idea to keep the wetsuit on to stay dry... It was pouring! The transition tent had mud puddles everywhere. The guy helping me with transition helped me get my socks and shoes on reminded me put on my helmet, and then wished me luck as I headed out to get my bike. I had a fleeting thought to put on my windbreaker but decided against it because if the rain let up and the sun came out I knew it would be way to hot. Well, the rain never let up.
It was raining hard enough that I didn't see any of the beautiful scenery that usually graces this course. For me, the rain was actually a blessing because I tend to overheat during races and the constant rain kept me cool. I had decided to take it easy on the bike. I knew that i had a long day ahead. Everyone was passing me. All ages, shapes, and sizes! halfway through the first lap I saw Louise pass me (our names are on our race numbers so fans can cheer for us) and I looked at her left calf, knowing that would be where her age was marked, and saw "65". I had to smile. I got passed by 65 year old Louise, and yet I knew that I had to let her go because otherwise I would have nothing left on the run. My bike was like that. I was passed by everyone! And it showed. After the swim I was 1000 overall. On the bike my time compared to everyone else was 1641. Only roughly 600 athletes had slower bike times than I did. But I stuck to my game plan. I had budgeted 7 hours for the bike. The last 10-15 miles was all uphill. Not extremely steep. But on the second lap, over 100 miles in, those last 10 miles of hills felt much steeper. There were some good motivational signs posted on the bike course along this last climb. My favorite being a quote from Winston Churchill "If you're going through hell, keep on moving". Amen to that! After the 45 mile mark I thought "this is the first time I've ridden this far in 3.5 months. After 92 miles I thought "this is the farthest I've ever biked", and at 100 miles into the bike I had done my first century ride ever. I was slow, but I was still moving!

Off the bike with an official time of 7:06:29 (65 year old Louise finished her bike in 6:36!!)

By this time I had been on the go for nearly 8.5 hours. I knew that if I could pull off a 4-4h30 marathon I would break my 13hr goal. I wasn't sure how my legs would respond after the bike, and I was pleasantly surprised as I started running and found myself at a pace that was actually running, rather than shuffling. I didn't wear a watch, so I had no idea how fast I was running, but I decided to just go with what felt good. Mark Allen, one of the best Ironman athletes, once said "the pain isn't that much greater if you run a little faster, but it's over sooner". Between that and Churchill I had some good lines going through my head. 26.2 miles... I decided to break it down by aid stations. I would run from station to station, approximately every mile, and then walk through the aid station getting coke, water, and Gatorade at first. I was feeling "fresh" through mile 3 still but felt like I was putting to much in my belly. It was all sloshing around each time I got out of the aid station area and started running again. So, I started having just half cups of water and coke. At about mile 4 I passed my friend Raf heading the opposite direction, which meant he was about 6 miles ahead of me. Which was about right since he was planning to finish the bike in 6 hours.

By mile 10 I decided to give the chicken broth they were offering a try. That stuff was a miracle for me! It calmed my stomach down and I felt great. From then on, I took chicken broth at every 3rd aid station. The rain was still dumping, which I liked. it wasn't all that cold, just soaking wet and kept me cool. Miles 5-13 I started telling myself "ok, just 13 miles to get back to this point" I tried to stay in high spirits by talking a bit with other athletes, and joking with volunteers. At the turn around point on the second lap, 18+ miles in, I told the volunteers "don't take this personally, but I'm really glad I won't see you again today!" By mile 21 I didn't want to get over confident, but I pretty much knew I was going to finish. It was an awesome feeling. Just a 10k to go I thought. Than with 3 miles left, just a 5k to go. I skipped the last aid station and ran strong through the last 2 miles. As I came down the hill and through the entrance to the oval and around to the finish line I was high fiveing everyone and pumping my fists in the air. I felt like I had all the energy in the world! It was an awesome feeling with everyone cheering and knowing that I was actually finishing, and finishing strongly. I crossed the finish line, was covered by a space blanket and guided through the finisher process, switching between a huge smile and uncontrollable tears. Unreal! "This is my first Ironman!"

Official Run time 4:21:14 (9:59 minute per mile average)

Official finish time: 12h 53m 54s

The volunteers along the course were great. They and tons of other friends and family, as well as general spectators from the local communities,stuck it out in the rain for 17 hours! And I couldn't have done this without all of your prayers and e-mails of support wishing me luck. I kept thinking about all of you who have supported me in so many ways and who contributed to Race4Kids, and I thought about how long all the volunteers and spectators had stood outside cheering on thousands of athletes that they don't know, feeding us, and encouraging us. I had to finish for all of you and it is because of all of you that I was able to finish. Thank you!

-Timo (Ironman) Acosta ;)

Friday, July 18, 2008

Update - Lake Placid - 40 hrs and counting!

Today is my second full day in Lake Placid. The excitement of the Lake Placid Ironman is in full force and has penetrated the entire community! The roads are full of cyclists and runners checking out the course and making last minute adjustments. Local restaurants have special meal choices, their staff sporting ironman hats and shirts, and local residents have banners hanging in their front yard. We definitely feel welcomed.

I'm here with my friend Rafael who is also doing the ironman on Sunday. We flew in from SFO late Wednesday night and have spent the last day and a half getting registered and familiar with the course. Yesterday we registered, tuned up our bikes and went for a 40 mile ride to check out part of the course. We first drove the course and noticed that there are a LOT of hills. This is arguably the most difficult Ironman in North America. Our ride took us over what some consider to be one of the toughest sections of the course, and it was surprisingly easy.... But we were also very fresh. We hit these same hills at around 45 miles and 100 miles into the course on sunday and I think these hills will feel like mountains. The run course is also pretty hilly, but then again I think even a drive way would feel like a wall by mile 20.

It has rained of and on today with a bit of thunder and lighting. Hopefully the moisture will be squeezed out before the race and we won't have to worry about the weather come race day. Tonight will be the mandatory athletes meeting and banquet, where we get to hear all the official rules and size up our competition while plowing down all-you-can-eat pasta, salad, and liquids!

Tomorrow I'll get to meet Rich, who has provided some training tips for me and is also the founder of Race4Kids. It is Rich's daughter who's picture is on the Race4Kids website. He sent a copy of his race strategy to all of us who will be part of the Race4Kids team (with Orange race jersey and all!) and his motivation through points in the run, when it really gets tough, is to think about how much his daughter has had to endure during her treatment over the past year. I can't wait to meet them and the others who have joined the team.

Thanks to all of you have have sent in donations over the past week and a half. There have been dozens of donations pouring in! Tomorrow will be a short swim, drop our bikes off, and rest.... 7am EST Sunday will be here before I know it. I'm very excited, and a bit nervous, just thinking about it.


Sunday, June 15, 2008

HEAL Africa 3 - the other guys 1!!!

Yesterday I was invited to play Futbal with the HEAL Africa staff at the main stadium in Goma. I've been wanting to enter the stadium since I arrived to watch a match and as it turns out my first visit was as a player.

What I thought would be a pick-up game of sorts ended up being quite serious. We had uniforms, refs, and fans! As is typical here I was told the match started at 15h and was worried when I was 5 minutes late, only to find out I was the first one there and the match didn't actually start to about 4:15. I was initially on the bench but before the match started I noticed there weren't enough players on our side, so I stood patiently by the side lines. When they looked over for another player I was right there and got to start the game. And I never left the field. They placed me at left back which suited me fine since it's a position I had played growing up.

Our team was surprisingly strong right from the opening whistle. The majority of the first half was played on the opponents side of the pitch with several shots just over the cross bars. Than with about 15 left in the first half we put one in the net... and the celebration was amazing. Kids came running on to the field doing cartwheels and our fans where jumping up and down in wild excitement. I felt like I played ok for having running shoes on a dirt pitch. I was sliding around a bit, but for the most part contained my side. I think mostly because I'm a mzungu, everyone was making a huge deal and high fives all around for my play on the field. I guess when the expectations are low, it doesn't take much to impress... ;

Second half we put in two more, with one coming off my cross from the left side, about 10 yard in from midfield. The ball just cleared the defended and the keeper was already too far out, so our forward redirected the ball with a header right over the keepers out stretched hand as he dove backward toward the goal.

The put one in on us through the middle of the field towards the end, but when the final whistle blew you would have though we won the world cup. The cheering and singing (oleee, ole, ole, oleeee....) was great. And as everyone piled into the hospital vehicles to head back to the hospital the sirens were blaring and horns honking as they plowed through the middle of the dirt pitch.... I now have been dubbed Zidane for our team, mostly because we have the same skin tone... ;) What an incredible experience. Unfortunately no pictures, but trust me, even if you don't enjoy futbal/soccer, you would have had fun witnessing this match and being a part of the fans on the sidelines.